title: Toxicology findings in suicides: concentrations of ethanol and other drugs in femoral blood in victims of hanging and poisoning in relation to age and gender of the deceased.
abstract: Over-consumption of alcohol and/or abuse of other drugs are closely linked to attempted or completed suicides. In this retrospective 10-year study (2001-2010), we compared the toxicology findings in hanging suicides (n = 4551) with drug poisoning (intoxication) suicides (n = 2468). The mean age of hanging deaths was 49 ± 19 y (±SD) and 80% were male, compared with a mean age of 52 ± 17 y and 47% males for the intoxication deaths. Poly-drug use was more common in poisoning suicides with an average of 3.6 drugs/case compared with 1.8 drugs/case in hangings. Moreover, 31% of hangings were negative for alcohol and/or drugs. Alcohol was detected (>0.20 g/L) in femoral blood in 30% of hanging suicides (mean 1.39 g/L) and 36% of drug poisonings (mean 1.39 g/L). The median BACs did not depend on the person's age or gender (p > 0.05). Ethanol, paracetamol, citalopram, diazepam, propiomazine, alimemazine and zopiclone were amongst the top-ten drugs detected in both methods of suicide. With the exception of ethanol, the concentrations of drugs in blood were considerably higher in the poisoning deaths, as might be expected. Regardless of the method of suicide, antidepressants and/or antipsychotics were common findings, which could implicate mental health as a significant suicide risk factor.
authors.affiliation: Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden; Department of Clinical Pharmacology, Linköping University, Faculty of Health Sciences, Linköping, Sweden. Electronic address: wayne.jones@liu.se.
authors.forename: Alan Wayne
authors.initials: AW
authors.lastname: Jones
authors.forename: Anita
authors.initials: A
authors.lastname: Holmgren
authors.forename: Johan
authors.initials: J
authors.lastname: Ahlner
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000928:Antidepressive Agents / Q000097:blood; D014150:Antipsychotic Agents / Q000097:blood; D001237:Asphyxia / Q000401:mortality*; D002492:Central Nervous System Depressants / Q000097:blood; D000431:Ethanol / Q000097:blood; D005260:Female; D053593:Forensic Toxicology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000401:mortality*; D011041:Poisoning / Q000401:mortality*; D012189:Retrospective Studies; D017678:Sex Distribution; D013405:Suicide / Q000706:statistics & numerical data* / Q000639:trends; D013548:Sweden; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D002492:Central Nervous System Depressants; D000431:Ethanol
keywords: Alcohol; Blood; Drugs; Hanging; Poisoning; Suicides; Toxicology